ICE VERSUS HEAT

The most common question I get from people is “When should I use ice and when should I use heat?”. Most experts recommend using ice in the acute phase of an injury and using heat in the chronic phase. People remain confused because it’s not always easy to determine which of those categories their pain fits in. Should you grab an ice pack for your shoulder or a heat pack when an old rotator cuff injury flares up? When your neck hurts after sitting at your desk should you grab an ice pack for your neck or use a heating pad? Should you use an ice pack for your hip when your tendonitis flares up or get into a jacuzzi? I recommend using ice in almost every instance of pain. Why? Because whether your condition is chronic or acute, most pain is associated with inflammation.

Most pain comes from injured tissue like muscles, nerves, disks, tendons, ligaments, bursa, and joints. When these tissues suffer trauma the body immediately responds with inflammation. There are 5 classic signs of inflammation: redness, heat, swelling, pain, and loss of function. In an acute injury like a sprained ankle, or a fall, you may experience many or all of the signs of inflammation. You feel the pain and heat, see the redness and swelling, and experience the loss of function. It’s easy to recognize that inflammation is present and ice will be the obvious choice. But in a flare up of an old injury, it is not as easy to recognize the inflammation. You may have pain without seeing any redness or swelling. You may conclude that inflammation is not present because you don’t see it. But just because you don’t see all of the signs of inflammation does not mean that it isn’t there. Let me explain.

When any tissue gets injured, even scar tissue from a chronic condition, the body responds with inflammation. Scar tissue by nature is less flexible than original uninjured tissue and is more vulnerable to injury. It takes less stress or trauma to injure scar tissue. This is why so many people experience flare ups without even knowing what caused it. They don’t recall any trauma that stressed the area. That’s because the trauma may have been from something insignificant like adding a couple of pounds to a weight workout, or getting up wrong, or sitting in a new chair, or wearing a different pair of shoes. Whatever the cause, somehow the tissue got traumatized and the body responded with inflammation as it always does in response to trauma. The inflammation may be minor or may be deep enough inside a joint or muscle to be invisible to the naked eye. But just because you can’t see it does not mean it isn’t present. In general if there is pain there is inflammation. Ice reduces inflammation while heat may aggravate it, so ice is also the safest choice. (see when not to use ice)

When you have pain, whether chronic or acute, grab your TheraPouch™ and use it as an ice pack for your shoulder, an ice pack for your hip, an ice pack for your neck, or for wherever you hurt. (instructions)

INFLAMMATION

Inflammation is our body’s biological response to harmful stimuli. Harmful stimuli can be physical, chemical or biological (germs, virus’, pathogens) The body responds by sending plasma and cells to the area to stop the damage, protect the tissue from further damage, and start the healing process. Inflammation is a protective process and our body’s most powerful defense mechanism. If the harmful stimulus is removed, the inflammation process will progress into the repair process. (How tissues heal). If the harmful stimulus remains present and continues to cause damage, a condition of simultaneous destruction and healing will lead to pathological changes in the tissue.

HOW TISSUES HEAL (3 PHASES OF HEALING)

There are 3 sequential and overlapping phases of healing that occur after any trauma. The first phase is inflammation, the goal of which is to stop any bleeding, destroy pathogens, and protect the area from further damage. During inflammation, platelets assist in clotting, macrophages remove debris, leucocytes and other cells fight infection, and plasma acts to splint the area. The second phase of healing is the proliferative phase, characterized by the formation of new tissue to repair damaged tissue. During this phase collagen and fibrin are laid down to repair damaged connective tissue, and angiogenesis occurs for blood vessel repair. The third phase of healing is the remodeling and maturation phase. During this phase, the collagen that was laid down in phase 2 is remodeled and realigned according to stresses placed on the tissue. The more favorable the stresses, such as with functional rehabilitative exercises, the more favorably the tissue will remodel, creating better functioning scar tissue. This final phase of healing lasts from 3 weeks up to 2 years and is largely one of improvement in quality of scar tissue.